Psychiatric disorders in first-degree relatives of children with pediatricautoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)

Objective: To determine the rates of psychiatric disorders in the first-deg ree relatives of children with infection-triggered obsessive-compulsive dis order (OCD) and/or ties (pediatric autoimmune neuropsychiatric disorders as sociated with streptococcal infections; PANDAS). Method: The probands of th is study were 54 children with PANDAS (n = 24 with a primary diagnosis of O CD; n = 30 with a primary diagnosis of a tic disorder). One hundred fifty-s even first-degree relatives (100 parents [93%] and 57 siblings [100%]) were evaluated for the presence of a tic disorder. One hundred thirty-nine firs t-degree relatives (100 parents [93%] and 39 of 41 siblings over the age of 6 [95%]) were evaluated with clinical and structured psychiatric interview s to determine the presence of subclinical OCD, OCD, and other DSM-IV Axis I disorders. Results: Twenty-one probands (39%) had at least one first-degr ee relative with a history of a motor or vocal tie; 6 mothers (11%), 9 fath ers (19%), and 8 siblings (16%) received this diagnosis. Fourteen probands (26%) had at least one first-degree relative with OCD; 10 mothers (19%), 5 fathers (11%), and 2 siblings (5%), received this diagnosis. An additional 8 parents (8%) and 3 siblings (8%) met criteria for subclinical OCD. Eleven parents (11%) had obsessive-compulsive personality disorder. Conclusions: The rates of tic disorders and OCD in first-degree relatives of pediatric p robands with PANDAS are higher than those reported in the general populatio n and are similar to those reported previously for tic disorders and OCD. F urther study is warranted to determine the nature of the relationship betwe en genetic and environmental factors In PANDAS.